Retrospective analysis of the impact of symptom duration on prognosis in soft tissue sarcoma

The objective was to assess whether time to diagnosis is influenced by patient/tumour-related factors and whether or not duration of symptoms has any impact on survival in soft tissue sarcoma. The study was an analysis of prospectively collected data for patients treated at our centre over a 20-year period. Risk factors were assessed by Kaplan-Meier analysis and the Cox proportional hazards model. Of 1,508 patients, 159 had metastatic disease at diagnosis and were excluded from analyses. In the remaining 1,349 patients overall 5-year survival was 60%. Duration of symptoms had a significant impact on survival (p=0.0037) with each additional week of symptoms reducing the monthly hazard rate by 0.2%. Patient and tumour-related factors significantly associated with longer symptom duration were low-grade, subcutaneous tumours, and epithelioid or synovial sarcoma. Symptom duration was not associated with age/gender or tumour size. Patients with long symptom durations tend to have low-grade disease and a more favourable outcome than patients who experience short symptom durations.